L17- RTI VI Flashcards
list the three ways pneumonia is classified
- area of lung affected: lobar, bronchopneumonia, interstitial
- acquisition: CA, HA, ventilator associated
- causative agent: bacterial, viral, others (fungi)
list the common CA-pneumonia pathogens
- *S. pneumoniae
- *Mycoplasma pneumoniae
- *Chlamyodophila pneumoniae
- Haemophilus influenza
-Respiratory viruses (milder form, stems from URI)
list the common HA-pneumonia pathogens (differentiate by group)
(MDR- multi-drug resistant)
Non-MDR pathogens: *S. pneumoniae, H. influenzae, MSSA (meth. sens. S. aureus); Antibiotic-Sensitive Enterobacterieae: E. coli, *Klebsiella pneumoniae
MDR pathogens: *pseudomonas aeruginosa, MRSA; Anitbiotic Resistant Enterobacteriaceae
list the common causes of ‘typical’ pneumonia
- Strep. pneumoniae
- Klebsiella pneumoniae
- H. influenzae
- Staph. aureus
Clinical features of ‘typical’ pneumonia:
- (1) parts of lung involved
- (2) acute Sxs
- (3) signs of consolidation
1- one lobe affected
2- (acute onset) high fever, pleuritic chest pain, productive cough
3- dullness, vocal fremitus / resonance, egophony, whispered pectoriloquy, bronchial breath sounds
‘typical’ pneumonia:
- (1) list the phases
- (2) what are the diagnostic techiniques
1- i) consolidation, ii) red hepitization, iii) gray hepitization, iv) resolution
2- *CXR, sputum analysis, blood cultures
Strep. pneumoniae, aka (1), and causes the following infections, (2)
1- pneumococcus, diplococcus
2- pneumonia, sinusitis, otitis media
describe the distinguishing S. pneumoniae culture features
- α-hemolysis
- Optochin sensitive
describethe distinguishing S. pyogenes culture
- β-hemolysis (due to Streptolysin S)
- Bacitracin sensitive
- PYR+
(1) is the most common cause of CA-pneumonia. It is normally found in (2) and is transmitted in (3) fashion. Highest incidences are in the (4) season.
1- Strep. pneumoniae
2- nasopharyngeal flora (no animal / environmental reservoir)
3- endogenous OR exogenous person to person thru droplets
4- winter, early spring
S. pneumoniae has ______ as its hallmark symptom
rusty sputum: red-brown colored sputum
list the important virulence factors for S. pneumoniae
- Capsule: anti-phagocytic, evades immune response
- IgA protease
- Pneumolysin (many functions, on another slide)
- Autolysin
- Transformation
list the properties and functions of Pneumolysin found in S. pneumoniae
- inhibits ciliated epithelial cell activity
- *Cytotoxic for alveolar / epithelial cells
- causes inflammation + dec PMN effectiveness
list the pneumococcal pneumonia vaccinations and their indications
Pneumovax 23 (inactivated):
- 23 serotypes of different capsular polysaccharides
- for >65 y/o or smokers or those with certain medical conditions
Prevnar 13 (conjugated):
- 13 serotypes of capsular polysaccharides conjugated to a protein
- children <2y/o, adults >65y/o, or those with certain medical conditions
what is a key change to S. pneumoniae seen over the past few decades
significant inc in penicillin (and antibiotic) resistance (more than any other microbe)